64 years old male with non descriptive visceral pain in the periumbilical region, followed by nausea. Previous radiography study don`t help. Previous US study shows signs of inflamed mesenteric fat on right lower quadrant.
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Right lower quadrant: dilated appendix with a small appendicolith inside; inflammatory phlegmon as well.
The prevalence of appendicitis in patients who present with abdominal pain to the emergency department is approximately 14%.
Traditionally, acute appendicitis has been diagnosed on the basis of clinical findings.
CT is highly sensitive (94 - 98%) and specific (up to 97%) for the diagnosis of acute appendicitis, and allows for alternative causes of abdominal pain to also be diagnosed. In this case, a simple non-contrast study, as institution protocol, was enough to determine the diagnosis.